AAP recommends both nasal spray and flu shot for 2019-2020 season

Yvonne Maldonado

The AAP recently announced that children can be vaccinated with either an inactivated influenza vaccine or a live-attenuated influenza vaccine for the 2019-2020 influenza season.

Last year, the academy recommended that children aged 6 months and older should be vaccinated with the inactivated influenza vaccine (IIV), which is administered via injection. The live-attenuated influenza vaccine (LAIV), which is sprayed into the nose and often preferred by parents and patients, was only recommended if the child refused IIV. This update is in agreement with the CDC’s influenza vaccine recommendations.

Yvonne Maldonado, MD, FAAP, chief of pediatric infectious diseases at Stanford University and chair of the AAP’s Committee on Infectious Diseases, told Infectious Diseases in Children that there was no one piece of evidence that compelled the academy to change its stance but a growing collection of data over time.

“We had seen that the original formulation of LAIV was not effective for children, so the company reformulated one of the strains,” she said, referring to the A(H1N1)pdm09 virus strain. “Last year, we did not feel we had enough overall evidence that LAIV was an effective vaccine compared with IIV. This year, we thought the totality of the data was strongly suggestive that there was effectiveness in the strain included in LAIV.”

The AAP announced its decision in time for providers to order the vaccine for the upcoming influenza season.

“We have confidence that [LAIV] can be used alongside any of the other vaccine formulations,” Maldonado said. “We would encourage providers that all children, and anybody aged 6 months and older, get vaccinated against influenza every year. It is a major illness and causes dozens of deaths in children and adults every year.” – by Katherine Bortz

Disclosure: Maldonado reports being on a data safety monitoring board for a Pfizer clinical trial unrelated to influenza vaccination.